COVID-19 Update NOVEMBER 19, 2020 - QUESTIONS: First Nations Telehealth Portal

 
COVID-19 Update NOVEMBER 19, 2020 - QUESTIONS: First Nations Telehealth Portal
COVID-19 Update
NOVEMBER 19, 2020

                QUESTIONS: VCHELP@FNTN.CA
COVID-19 Update NOVEMBER 19, 2020 - QUESTIONS: First Nations Telehealth Portal
Outline
1. COVID-19 in Alberta
◦ Dr. Deena Hinshaw, Chief Medical Officer of Health – Alberta Health
◦ Amy Colquhoun, Manager, Population Health Assessment - Alberta Health
◦ Lea Bill, Executive Director - Alberta First Nations Information Governance Centre
2. FNIHB MOH Update
◦ Dr. Wadieh Yacoub and Dr. Chris Sarin
3. Alberta Indigenous Virtual Care Clinic
◦ Michelle Hoeber, Program Lead, Telehealth – TSAG

4. Questions

                         QUESTIONS: VCHELP@FNTN.CA
COVID-19 Update NOVEMBER 19, 2020 - QUESTIONS: First Nations Telehealth Portal
COVID-19 in Alberta
       Dr. Deena Hinshaw (Ministry of Health)
       Trish Merrithew-Mercredi (Ministry of Health)
       Lea Bill (Alberta FNIGC)
       Amy Colquhoun (Ministry of Health)

      November 19, 2020

Classification: Protected A
COVID-19 Update NOVEMBER 19, 2020 - QUESTIONS: First Nations Telehealth Portal
Agenda

        1. Overview of COVID-19 data and reporting in Alberta

        2. COVID-19 in First Nations People in Alberta

        3. Questions: Health Zones, Maps, Testing Approach, Contact Tracing

        4. AFNIGC: community data approaches

4
Classification: Protected A
COVID-19 Update NOVEMBER 19, 2020 - QUESTIONS: First Nations Telehealth Portal
COVID-19: data sources
                              Sources                             Information (examples)
                              Public Health Laboratory            • Number of people tested
                              (ProvLab)                           • Number of tests completed
                                                                  • Results of tests (e.g. positive)
                              Communicable Disease &              • Cases and their contacts
                              Outbreak Management (CDOM)          • Outbreaks
                                                                  • Deaths
                              Alberta Health Services Analytics   • Hospital (ICU and nonICU) admission and
                              team (DIMR)                           discharge
                              Alberta Health Disease Registry     • Pre-existing conditions (comorbidities)

                              Alberta Health Care Insurance       • COVID-related information among First
                              Plan (historic fees)                  Nations in Alberta

5
Classification: Protected A
COVID-19 Update NOVEMBER 19, 2020 - QUESTIONS: First Nations Telehealth Portal
COVID-19: daily reporting (examples)
        • Cases: new, active, recovered

6
Classification: Protected A
COVID-19 Update NOVEMBER 19, 2020 - QUESTIONS: First Nations Telehealth Portal
COVID-19: daily reporting (examples)

        • Severe Outcomes:
                – Hospitalizations (ICU, nonICU)
                – Deaths
                – Comorbidities

7
Classification: Protected A
COVID-19 Update NOVEMBER 19, 2020 - QUESTIONS: First Nations Telehealth Portal
COVID-19: daily reporting (examples)
       • Testing: people tested, number of tests, percent positivity

8
Classification: Protected A
COVID-19: First Nations report

      •      Available via email and
             on the AFNIGC website
             (afnigc.ca)
      •      Contains less
             information compared
             to ‘all Alberta’
             dashboard due to
             potential confidentiality
             issues

9
Classification: Protected A
COVID-19: First Nations report

                              All Alberta   First Nations in Alberta

Classification: Protected A
COVID-19: First Nations report

                                                                                       First Nations in
                                        All Alberta
                                                                                       Alberta

                              •   First Nations people more likely to be hospitalized
11
Classification: Protected A
                              •   First Nations people experiencing severe outcomes are younger
Questions: Health Zone
                                                                                                                                                                                                                  Rate of active cases
                                                     Number of active cases                                                                                                                                   (factors in population size)
                                  160                                                                                                                                                  450

                                                         North Zone                                                                                                                                     North Zone
                                  140                                                                                                                                                  400
                                                         Edmonton Zone                                                                                                                                  Edmonton Zone

                                                                                                                                             COVID-19 active case rate (per 100,000)
                                                                                                                                                                                       350
Number of active COVID-19 cases

                                  120                    Central Zone                                                                                                                                   Central Zone
                                                         Calgary Zone                                                                                                                  300
                                  100                                                                                                                                                                   Calgary Zone
                                                         South Zone
                                                                                                                                                                                       250              South Zone
                                  80
                                                                                                                                                                                       200

                                  60
                                                                                                                                                                                       150

                                  40
                                                                                                                                                                                       100

                                  20                                                                                                                                                   50

                                    0                                                                                                                                                    0
                                   3/4/2020   4/4/2020     5/4/2020      6/4/2020   7/4/2020   8/4/2020   9/4/2020   10/4/2020   11/4/2020                                              3/4/2020   4/4/2020    5/4/2020   6/4/2020   7/4/2020   8/4/2020   9/4/2020   10/4/2020   11/4/2020

12                                                                                                             First Nations in Alberta
Classification: Protected A
Questions: Health Zone

             Cases had the following types of exposure:
                -     37% (558/1,523) were a close contact
                      of a known case
                -     44% (668/1,523) had an unknown
                      exposure
                -     16% (237/1,523) were linked to an
                      outbreak
                -     4% (60/1,523) were related to travel

13
Classification: Protected A
Questions: maps

       • Two different
         geographies:
         municipality and local
         geographic area
       • Total cases, active
         cases, recovered,
         deaths

14
Classification: Protected A
Questions: maps
             • Relaunch map
             • Municipalities only
               (except in Edmonton and
               Calgary)
             • Threshold: more than 10
               active cases and a rate
               of 50 or more (per
               100,000)
             • Enhanced measures in
               place
15
Classification: Protected A
Questions: testing approach
            • Recent change to focus testing capacity on highest
              value testing
                    – Symptomatic, Outbreaks, and Known Exposures
            • In high risk situations, MOHs can authorize targeted
              expanded testing for a limited time
                    – e.g. gathering with an unknown number of exposures
            • Testing value is highest with fast turn around times –
              increasing speed is the reason for focused testing

16
Classification: Protected A
Questions: AHS contact tracing change
         • With increased case numbers, AHS contact tracers
           are not able to keep up.
         • Until capacity is increased, cases will be asked to
           notify their own contacts except for priority settings
           (health care and continuing care).
         • An online portal to make contact tracing more
           efficient has been activated as of last week.

17
Classification: Protected A
AlbertaFNIGC
         • Sit on the advisory committee for COVID-19 testing
         • Distribute information on AlbertaFNIGC website regarding
           weekly counts as received from Alberta Health
         • Created an educational document – “COVID-19 Information
           for First Nations in Alberta” that is available on the
           AlbertaFNIGC website (afnigc.ca)
         • Provide links to updated research documents, websites, and
           reputable scientific YouTube videos to explain COVID-19
           and any ongoing developments

18
Classification: Protected A
Questions?
      VCHELP@FNTN.CA

                              https://www.alberta.ca/covid-19-alberta-data.aspx

Classification: Protected A
Appendix

20
Classification: Protected A
COVID-19 Vaccine
Government of Canada is tracking all potential drugs and vaccines in
development in Canada and abroad.
Only vaccines that are safe and effective will be approved for use in Canada.
Because there will be limited quantities at first, once a vaccine is approved for
use, key populations will need to be prioritized.
◦ Governments will work together and continue to seek input from independent experts, like
  the National Advisory Committee on Immunization (NACI), to make decisions about how to
  prioritize vaccination

                          QUESTIONS: VCHELP@FNTN.CA
COVID-19 Vaccine
Key priority populations include:
- Those at high risk of severe illness and death from COVID-19
- Those most likely to transmit COVID-19 to those at high risk of severe illness and death from
COVID-19 and workers essential to maintaining the COVID-19 response
- Those contributing to the maintenance of other essential services for the functioning of society
- Those whose living or working conditions put them at elevated risk of infection and where
infection could have disproportionate consequences, including Indigenous communities

                             QUESTIONS: VCHELP@FNTN.CA
COVID-19 Vaccine
Resources:
GOC: What you need to know about the COVID-19 vaccine for Canada
https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/awareness-
resources/know-vaccine.html
GOC: Drugs and vaccines for COVID-19: List of authorized clinical trials
https://www.canada.ca/en/health-canada/services/drugs-health-products/covid19-industry/drugs-vaccines-
treatments/list-authorized-trials.html
GOC: Preliminary guidance on key populations for early COVID-19 immunization
https://www.canada.ca/en/public-health/services/immunization/national-advisory-committee-on-immunization-
naci/guidance-key-populations-early-covid-19-immunization.html
WHO: Coronavirus disease (COVID-19): Vaccines
https://www.who.int/news-room/q-a-detail/coronavirus-disease-(covid-19)-vaccines?gclid=Cj0KCQiA-
rj9BRCAARIsANB_4AAxOObqLWgELI_aRRKE8mHuBXJzfxyZze3E-RdyCfC1vkgJT0rpk5caAsR2EALw_wcB

                                  QUESTIONS: VCHELP@FNTN.CA
Targeted Public Health Measures
New targeted public health measures were announced on November 12.
Targeted measures apply to all communities on the enhanced list (purple zones).
Additional measures may apply to the Calgary and Edmonton areas, and the
cities of Fort McMurray, Grande Prairie, Lethbridge and Red Deer.
Unless otherwise indicated, measures are in place until we see less stress on our
health care system.
See GOA COVID-19 Info for Albertans website for more information:
https://www.alberta.ca/enhanced-public-health-measures.aspx

                        QUESTIONS: VCHELP@FNTN.CA
Mandatory Targeted Public Health Measures
                                 All enhanced Calgary &   Edmonton   Fort       Grande    Lethbridge Red Deer
                                 (purple) zone Area       & Area     McMurray   Prairie
                                 areas
15-person limit on family &
social gatherings (CMOH 36-                                                                       
2020)

50-person limit on wedding
and funeral services (indoor &                                                                    
outdoor) (CMOH 37-2020)

Ban on indoor group fitness
classes & team sports (Nov                                                                        
13-27) (CMOH 37-2020)

Ban on group singing, dancing
& performing activities (Nov                                                                      
13-27) (CMOH 37-2020)

Restaurants/pubs stop liquor
sales by 10pm, close by 11pm                                                                      
(Nov 13-27) (CMOH 37-2020)

                                          QUESTIONS: VCHELP@FNTN.CA
Voluntary Targeted Public Health Measures
                           All enhanced Calgary &   Edmonton &   Fort       Grande    Lethbridge   Red Deer
                           (purple) zone Area       Area         McMurray   Prairie
                           areas
Mask use encouraged in
all indoor workplaces                                                                           

Employers in office
settings to reduce                                                                              
employees in the
workplace at one time

Faith-based gatherings
limited to 1/3 capacity                                                                         

Limit of 3 cohorts, plus
child care                                                                                      

No social gatherings
inside your home or                                                                             
outside of your
community                                QUESTIONS: VCHELP@FNTN.CA
Indoor Gathering Limits
                   Social Gatherings                                            Audience Event
Mandatory Limit (applies to communities on the enhanced   Mandatory Limit for wedding and funeral services (applies to
list): 15 people                                          communities on the enhanced list): 50 people
CMOH Order 36-2020                                        CMOH Order 37-2020

Limit (for communities not on the enhanced list):         Voluntary Limit (communities on the enhanced list): Faith-
50 people                                                 based gatherings limited to 1/3 capacity at one time

                                                          Limit on seated audience event (for communities not on the
                                                          enhanced list): 100 people

            Social gatherings are where people:                        Audience-type events are where people:
              - move freely to mix with others            - are seated spectators of an organized performance or activity
                - have two-way conversations                           - maintain 2 metres distance from others
               - share food, laugh, play games                      - limit movement and interaction with others
                                                                - receive one-way information (not conversational)

                                        QUESTIONS: VCHELP@FNTN.CA
Reminder - Enforcement of Public Health Orders
Individuals who violate a public health order may be subject to a $1,000 fine. Courts can also
administer fines up to $100,000 for a first offence and up to $500,000 for a subsequent offence
for more serious violations.
If you are concerned someone is not following public health orders:
• Remind the person that not following public health orders is against the law and puts people at
 risk.
• Speak with your local Community Health Nurse or CDC Case Manager.
• Submit a complaint to Alberta Health Services health inspectors online or by calling 1-833-415-
 9179. Complaints that require an immediate response can also be reported to your local police
 force.

                             QUESTIONS: VCHELP@FNTN.CA
FNIHB MOH Update
DR. WADIEH YACOUB, SENIOR MEDICAL OFFICER OF HEALTH
DR. CHRIS SARIN, DEPUTY MEDICAL OFFICER OF HEALTH

                 QUESTIONS: VCHELP@FNTN.CA
Reminder - Privacy
 All information related to an individual who is or was infected with a
  communicable disease shall be treated as private and confidential
 No information shall be published, released or disclosed in any manner
  that would be detrimental to the personal interest, reputation or privacy
  of that individual.

                       QUESTIONS: VCHELP@FNTN.CA
Current Situation – Canada (as of November 18)

Public Health Agency of Canada https://health-infobase.canada.ca/covid-19/dashboard/?stat=rate&measure=total_last14&map=hr&f=true#a2

                                        QUESTIONS: VCHELP@FNTN.CA
COVID-19 Across On-Reserve First Nations
Communities Canada by Status (All Provinces)
Source: FNIHB COVID-19 Epi Update (November 18, 2020)

                            QUESTIONS: VCHELP@FNTN.CA
COVID-19 in First Nations in Alberta (on Reserve
Only)
Source: FNIHB COVID-19 ER System via Synergy in Action (November 18, 2020)

               847              399              32                  38            11
           Confirmed and        Males           Impacted      Hospitalized     ICU ever
           Probable cases                     communities        ever
                                                  ever

                19                4             512                330             5
            Communities        Currently      Recovered            Active      Deaths
             with active      in Hospital
               cases
                                      Total Cases by Treaty Area                   Treay 6
                       390                       285                 172           Treaty 7
                                                                                   Treaty 8
           0     100    200     300     400     500    600     700     800   900

                                QUESTIONS: VCHELP@FNTN.CA
Age and gender distribution of on-reserve COVID-
        19 cases in comparison to all Alberta
          Source: FNIHB COVID-19 ER System via Synergy in Action (November 18, 2020)

                                   ALL ALBERTANS                                   FIRST NATIONS (ON RESERVE)

Source:
https://www.alberta.ca/stats/cov
id-19-alberta-statistics.htm
(November 17, 2020)

                                              QUESTIONS: VCHELP@FNTN.CA
Severe Outcomes
Sources: FNIHB COVID-19 ER System via Synergy in Action (November 18, 2020) &
https://www.alberta.ca/stats/covid-19-alberta-statistics.htm (November 17, 2020)

                                 QUESTIONS: VCHELP@FNTN.CA
Test Volume
Sources: Community Reports to FNIHB-AB (November 18, 2020)

                          QUESTIONS: VCHELP@FNTN.CA
Contributing Factors to Increased Cases
Sources: Community Reports to FNIHB-AB (November 18, 2020)
Gatherings
Non-essential travel
Community transmission
Challenges with isolation (Non-compliance)
Occupational exposure
Overcrowding

                           QUESTIONS: VCHELP@FNTN.CA
Important Reminders/
Updates

      QUESTIONS: VCHELP@FNTN.CA
Alberta COVID-19 Testing Criteria
Testing is available to:
 ◦ any person exhibiting any symptoms of COVID-19
 ◦ all close contacts of confirmed COVID-19 cases
 ◦ all workers and/or residents at specific outbreak sites

 Asymptomatic testing has been paused for people who have no known
 exposure to COVID-19.

FNIHB MOHs will provide guidance to prioritize testing in First Nation
communities with cases.

                              QUESTIONS: VCHELP@FNTN.CA
Reminder – Preventing Transmission in
Healthcare Settings
Preventing the risk of transmission amongst staff and clients/patients remains important.
Measures to prevent transmission in healthcare settings should continue to include:
- continuous masking (HCWs must wear a medical mask [procedural/surgical]),
- staff and client screening,
- restricting the number of staff and clients/patients in the setting at any one time;
- physical distancing between all individuals at all times;
- enhanced cleaning/disinfection

                                QUESTIONS: VCHELP@FNTN.CA
Updated Guidance – Non-Medical Masks
             and Face Coverings
             A non-medical mask or face covering can be homemade or purchased, and should:
               ◦ be made of at least 3 layers
                  ◦ 2 layers should be tightly woven material fabric, such as cotton or linen
                  ◦ the third (middle) layer should be a filter-type fabric, such as non-woven polypropylene fabric

               ◦ Filters add an extra layer of protection against COVID-19 by trapping small infectious particles. Consider
                 wearing a mask that includes a filter or filter material as one of its layers, such as:
                  ◦ non-woven polypropylene fabric, which can be found as:
                    ◦ a craft fabric
                    ◦ the non-woven fabric that's used to make some reusable shopping bags
                    ◦ a disposable filter inserted into a pocket on the mask

                  Reusable masks with a non-woven filter layer should be washed daily, and can be washed multiple
                  times. Disposable filters should be changed daily or as directed by the manufacturer.

Source: Public Health Agency of Canada https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/prevention-risks/about-non-
medical-masks-face-coverings.html#_blank

                                                           QUESTIONS: VCHELP@FNTN.CA
Outbreak-Related Definitions
Outbreak is defined as: “The occurrence of cases of disease in excess of what would normally be
expected in a defined community, geographical area or season” (World Health Organization,
2018).
 ◦ NOTE: A common source of infection or the identification of transmission between cases are not
   requirements for an outbreak. The epidemiologic features of an outbreak and subsequent public health
   actions are assessed through the outbreak investigation process.

Alert: A warning sign that the situation may evolve into an outbreak. The threshold for triggering
an alert is dependent on the specific setting.
Public Reporting: The minimum number of cases marking the threshold for public reporting of
COVID-19 outbreaks.

                              QUESTIONS: VCHELP@FNTN.CA
Definition of an Outbreak of COVID-19 by Setting
Type of Setting                Alert                       Outbreak                       Public Reporting
Congregate Settings         One symptomatic resident       One confirmed case             Two confirmed cases
(Continuing Care, Long-term or staff member
Care, Group home, DSL)
Child Care Facilities          One confirmed case OR two   Two confirmed cases            Five confirmed cases
(Daycares, Head Start, etc.)   symptomatic individuals     (staff/child) within 14 days
                               within 48 hours             or two confirmed cases that
                                                           are epidemiologically linked
Schools                        One confirmed case          Two confirmed cases within     Five confirmed cases
                                                           a 14 day period where
                                                           disease could have been
                                                           acquired or transmitted in
                                                           the school
Public Settings                n/a                         Five confirmed cases           Five confirmed cases
(Restaurants, Rec Centres,
etc.)

                                       QUESTIONS: VCHELP@FNTN.CA
Update - COVID-19 Alberta Health Daily
Checklist (For Children Under 18)
This new screening checklist (as of November 2) applies for all children, as well as all students
who attend kindergarten to Grade 12, including high school students over 18.
Children should be screened every day by completing this checklist before going to school, child
care or other activities.
Children may need a parent or guardian to assist them to complete this screening tool.
The checklist can be found at: https://open.alberta.ca/publications/covid-19-information-
alberta-health-daily-checklist

                             QUESTIONS: VCHELP@FNTN.CA
Alberta Indigenous Virtual Care Clinic
(AIVCC)
The Alberta Indigenous Virtual Care Clinic (AIVCC) has opened its virtual doors.
◦   Provides services to rural and urban First Nations, Métis and Inuit patients and families
◦   Provides same day, primary care services
◦   Services provided through a secure telephone and/or video system.
◦   Official public launch December 1, 2020

To book a same day appointment, please call 1.888.342.4822.
For more information please see:
◦ www.aivcc.ca or email info@aivcc.ca
◦ Facebook page - Alberta Indigenous Virtual Care Clinic

                              QUESTIONS: VCHELP@FNTN.CA
Is there a topic you
would like to hear about
at the next session?
P LEAS E LE T US KNOW!
E MAIL: VCHELP@FN TN .CA OR
S AC.CDEMERGE N CIES A B - URGE N CES M TA B .IS C @ C ANA DA .CA

                          QUESTIONS: VCHELP@FNTN.CA
Interested in presenting
your community’s COVID-
19 response/experience?
P LEAS E LE T US KNOW!
E MAIL: VCHELP@FN TN .CA OR
S AC.CDEMERGE N CIES A B - URGE N CES M TA B .IS C @ C ANA DA .CA

                          QUESTIONS: VCHELP@FNTN.CA
Acknowledgments
Dr. Deena Hinshaw, Chief Medical Officer of Health - Alberta Health
Lea Bill, Executive Director - Alberta First Nations Information Governance Centre
Amy Colquhoun, Manager, Population Health Assessment - Alberta Health
Trish Merrithew-Mercredi, ADM, Public Health and Compliance – Alberta Health
Dr. Wadieh Yacoub, Senior Medical Officer of Health -FNIHB
Dr. Chris Sarin, Deputy Medical Officer of Health - FNIHB
Simon Sihota, Regional Manager, Environmental Public Health Services – FNIHB
Ibrahim Agyemang, Senior Epidemiologist - FNIHB
TSAG Telehealth Team (Michelle Hoeber, Brooke Hames and team)
FNIHB Technical Team

                               QUESTIONS: VCHELP@FNTN.CA
Questions?
VCHELP@FNTN.CA

          QUESTIONS: VCHELP@FNTN.CA
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